Fungal infection in cancer patients are difficult to diagnose and such diagnoses are frequently only made at necropsy. Earlier, aggressive diagnostic procedures (see no. 06913 regarding bronchial brushing) have improved diagnostic accuracy and earlier therapy has become possible. Evaluation of epidemiologic factors has also identified the at risk population: Patients with positive nose cultures may have invasive disease and patients with sterile nose cultures are at risk of developing it. With the establishment of earlier diagnostic tests for systemic mycoses, we are testing the addition of rifampin to amphotericin-B to evaluate the known in vitro synergistic effect against many fungi. This treatment is used for suspected and documented fungal infections. Fifty patients have been randomly allocated to date, but after stratification for the various fungal infections, there are too few patients from which to draw meaningful conclusions other than that early application of therapy continues to be the best approach to infection resolution.